WP 2
Carotid Stenosis and Stroke

Prof. Dr. med. Lars Maegdefessel

Leiter der Sektion "Vaskuläre Biologie", Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, TUM

Prof. Dr. med. Martin Dichgans

Direktor Institut für Schlaganfall- und Demenzforschung, Klinikum der Universität München

Work Package 2: P4 Medicine for Carotid Stenosis and Stroke

Strokes are the second leading cause of death worldwide – with approximately 260,000 cases annually in Germany. A common cause is the narrowing of the carotid arteries (carotid stenosis) due to atherosclerotic plaques. Work Package 2 aims to develop new strategies for prediction and prevention using P4 medicine approaches (predictive, preventive, personalized, participatory).

Key Topics:

  • Biobank Analyses:
    Utilization of one of the world’s largest biobanks at the Klinikum rechts der Isar, containing over 1,250 standardized vascular specimens. Multi-omics analyses (genome, transcriptome, proteome) aim to identify markers correlated with the risk of plaque rupture and stroke.
  • Clinical Studies & Imaging:
    Collaboration with the Institute for Stroke and Dementia Research (LMU) to investigate genetic risk factors, biomarkers, and cognitive prognostic markers. Complemented by high-resolution plaque MRI for precise risk assessment.
  • Synergy of Data & Research:
    Linking biobank data with prospective stroke cohorts and clinical follow-up studies. Goal: new diagnostic markers and therapeutic approaches for personalized stroke prevention.

Added Value:
WP2 combines molecular analyses, clinical research, and state-of-the-art imaging to detect strokes earlier and enable individualized prevention strategies.

Results Work Package 2

P4 Medicine for Carotid Stenosis and Stroke

Overview

Work Package 2 is dedicated to investigating the molecular mechanisms of atherosclerosis and stroke, with a focus on the destabilization of plaques in the carotid artery and its clinical relevance.

Key Findings

  • Innovative sequencing methods:
    Using state-of-the-art transcriptome and proteome technologies, previously unknown genes and proteins have been identified that play a key role in the destabilization of atherosclerotic plaques and the development of strokes.
  • Interdisciplinary collaboration:
    Close collaboration with other work packages (particularly WP5.1 and WP5.2) enabled the generation of a globally unique dataset. This dataset combines clinical metadata (including imaging data from CT and ultrasound) with gene and protein expression data.
  • Clinical relevance:
    The integration of imaging and gene/protein data allows for improved risk stratification in patients with carotid stenosis.
    • New biomarkers have been developed to help determine whether surgery is indicated in asymptomatic patients.
    • New therapeutic targets have been discovered that determine the occurrence and severity of inflammatory smooth muscle cells. Blocking these targets can stabilize plaques and reduce the risk of stroke.
  • Data Protection and Security:
    New data protection standards and enhanced security measures for clinical and biomedical data sets have been established.

Sustainability and Outlook

  • The biomarkers and therapeutic approaches developed will be further refined in follow-up projects – some in collaboration with commercial partners – and prepared for clinical application.
  • The Munich Vascular Biobank (MVB), a resource expanded by DigiMed Bayern, provides high-quality tissue and blood samples for further molecular analyses and future research projects.
Conclusion for Work Package 2

Work Package 2 has made significant progress in the personalized prevention, diagnosis, and treatment of stroke and atherosclerosis. The integration of innovative molecular research, clinical data, and digital infrastructure is setting new standards for cardiovascular medicine in Bavaria and beyond.